Department of Pediatrics, All Children's Hospital Johns Hopkins Medicine, St Petersburg, Florida, USA.
Westat, Rockville, Maryland, USA.
Sex Transm Infect. 2015 Sep;91(6):458-61. doi: 10.1136/sextrans-2014-051712. Epub 2015 Jan 13.
To examine the HIV risk behaviours of men who have sex with men only (MSMO) and men who have sex with men and women (MSMW), aged 12-24 years, in five US cities and in San Juan, Puerto Rico.
Data were collected through four annual cross-sectional anonymous surveys at community venues and included questions about sexual partnerships, sexual practices including condom use and substance use. Demographic and risk profiles were summarised for both groups.
A total of 1198 men were included in this analysis, including 565 MSMO and 633 MSMW. There were statistically significant differences between the two groups for many risk factors examined in multivariable models. MSMW were more likely to identify as bisexual, be in a long-term relationship, have a history of homelessness, have ever used marijuana, have ever been tested for HIV and to have been tested for HIV within the past 6 months. MSMW may be more likely to ever exchange sex for money and ever have a sexually transmitted infection than MSMO.
MSMW were more likely to report several markers of socioeconomic vulnerability or behaviours associated with increased risk for HIV than MSMO. MSMW contribute to HIV prevalence in the USA, and better understanding of the risk profile of this group is essential to understand heterosexual HIV transmission. MSMW, particularly those who identify as bisexual or questioning, may feel uncomfortable participating in programmes that are designed for gay-identified men. Therefore, prevention strategies need to target distinct subgroups that compose the population of MSM.
研究仅与男性发生性行为的男男性行为者（MSMO）和与男性及女性发生性行为的男男性行为者（MSMW）中，年龄在 12-24 岁之间的 HIV 风险行为。
数据通过在美国五个城市和波多黎各圣胡安的社区场所进行的四次年度横断面匿名调查收集，包括关于性伴侣关系、包括安全套使用和药物使用在内的性行为以及物质使用的问题。对这两个群体的人口统计学和风险特征进行了总结。
共有 1198 名男性参与了这项分析，其中包括 565 名 MSMO 和 633 名 MSMW。在多变量模型中，两个群体在许多风险因素方面存在统计学显著差异。MSMW 更有可能被认定为双性恋，处于长期关系中，有过无家可归的经历，曾使用过大麻，曾接受过 HIV 检测，并且在过去 6 个月内接受过 HIV 检测。MSMW 可能比 MSMO 更有可能出于金钱目的发生性行为，并且更有可能患有性传播感染。
MSMW 更有可能报告一些社会经济脆弱性指标或与 HIV 风险增加相关的行为，而 MSMO 则不太可能报告这些指标或行为。MSMW 对美国的 HIV 流行做出了贡献，因此更好地了解该群体的风险特征对于理解异性恋 HIV 传播至关重要。MSMW，特别是那些被认定为双性恋或有疑问的人，可能会感到不舒服参与专为同性恋男性设计的计划。因此，预防策略需要针对构成 MSM 人群的不同亚群。
